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Prognostic value of brachial-ankle pulse wave velocity in patients with non-ST-elevation myocardial infarction

Park, Hyun Woonga; Kang, Min Gyua; Kim, Kyehwana; Koh, Jin-Sina; Park, Jeong Ranga; Hwang, Seok-Jaea; Jeong, Young-Hoonb; Ahn, Jong Hwab; Jang, Jeong Yoonb; Kwak, Choong Hwanb; Park, Yongwhib; Hwang, Jin-Yonga

doi: 10.1097/MCA.0000000000000529
Original Research
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Objective Brachial-ankle pulse wave velocity (baPWV) measurement is a well-established modality for assessing arterial stiffness and predicting cardiovascular events. However, to our knowledge, its usefulness has not been clarified among patients with non-ST-elevation myocardial infarction (NSTEMI). This study assessed the prognostic value of baPWV in patients with NSTEMI.

Patients and methods Patients (n=411, mean age, 63.8±13.5 years, 75.2% men) with NSTEMI who underwent a percutaneous coronary intervention and baPWV measurement were recruited between January 2013 and December 2015. Cardiac mortality and major adverse cardiovascular events (MACE) including cardiac death, re-acute myocardial infarction, revascularization, heart failure, and stroke after discharge were analyzed. The mean follow-up duration was 350 days.

Results MACE and cardiac mortality occurred in 26 (6.3%) patients and 13 (3.1%) patients. Kaplan–Meier survival curves showed that MACE and cardiac mortality were significantly higher in patients with high baPWV (1708.0 cm/s). In multivariable Cox regression analysis, high baPWV (hazard ratio: 2.55; 95% confidence interval: 1.03–6.30, P=0.043) was an independent predictor of MACE even after adjusting for possible confounders.

Conclusion Our findings indicate that baPWV was a strong independent prognostic factor of MACE in patients with NSTEMI. This suggests that baPWV can be a useful prognostic factor in the clinical setting for easier and less invasive prediction of MACE in patients with NSTEMI.

aDivision of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju

bDivision of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea

Correspondence to Jin-Yong Hwang, MD, PhD, Department of Internal Medicine, Division of Cardiology, Gyeongsang National University Hospital, Jinju 52727, Korea Tel: +82 557 508 155; fax: +82 557 509 078; e-mail: jyhwang@gnu.ac.kr

Received May 7, 2017

Received in revised form June 7, 2017

Accepted June 14, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.